Friday, April 26, 2013

In the 1800s, most people received medical treatment at home. There were few hospitals in the United States, and most of them cared for the very poor or the insane. The numbers and scale of military hospitals during the Civil War, however, changed this situation. Today, hospitals are an accepted feature of everyday life.

New systems developed rapidly to cope with the thousands of battle casualties. Triage sorted the wounded by the severity of their injuries and the treatment needed. Near the battlefield, tents often served as temporary field hospitals. Existing buildings were also used, but these were often dark, dirty and stuffy, lacking the space and ventilation of tents.

In previous wars, wounded soldiers had sometimes remained on the battlefield for days before being rescued. During the Civil War, however, special ambulance corps moved patients to field hospitals, helping to ensure that they received care sooner. Men who needed more extensive treatment or longer recuperation could then be transported by train to general hospitals in major cities. Some steamboats were even converted into floating hospitals.

The city of Philadelphia played a large role in treatment of the wounded. In addition to being a center for medical education, it was located at the intersection of several train lines. There were 24 military hospitals, plus branches, in the city at one time or another, in addition to the 22 small civilian hospitals that also treated troops. By the end of the war, Philadelphia hospitals had cared for about 157,000 soldiers and sailors. There were only four military hospitals elsewhere in the state: in Chester, south of Philadelphia; in York, south of Harrisburg; at White Hall in Montour County, near Williamsport; and in Pittsburgh. Because of racial discrimination, African American soldiers often received inferior medical treatment on the field and in hospitals, with few doctors and nurses willing to care for them.

Some Philadelphia military hospitals reused older buildings. For instance, Haddington Hospital at 65th and Vine Streets, with 200 beds, was housed in the old Vine Street Tavern. Most city hospitals had fewer than 500 beds, but two of the largest military hospitals in the country were located in Philadelphia. West Philadelphia or Satterlee General Hospital, with more than 3,000 beds, was built where Clark Park now stands. Mower General Hospital was located on the Reading Railroad line in Chestnut Hill. Designed by John McArthur, the architect of Philadelphia City Hall, it could accommodate 4,000 patients. These new hospitals were constructed using the “pavilion system.” They featured long, narrow wards, built quickly out of wood and arranged in a grid or a radiating pattern. Since bad air was thought to spread infection, the wards had large windows and extensive ventilation systems.

Hospitals required many workers: surgeons, nurses, administrators and clerical staff, cooks, laundresses and a host of others. At the start of the war, most nurses were male, since women were not supposed to take care of men who did not belong to their families. Gradually, however, white female nurses (including Catholic nuns) became more common, either as paid workers or as volunteers. Though African American women often served as hospital cooks or laundresses in the North, a small number were also hired as nurses. Organizations run by volunteers, such as the U.S. Sanitary Commission and the U.S. Christian Commission, contributed greatly to patient care, donating money, supplies and labor. Women throughout Pennsylvania were active in these groups and in many other volunteer organizations. The Sanitary Fairs of 1864 raised large sums of money for the Sanitary Commission’s work, with Pittsburgh’s fair bringing in $300,000 and Philadelphia’s earning over $1 million.

Philadelphia also hosted specialty hospitals, most notably the Turner’s Lane Hospital run by prominent physician Dr. S. Weir Mitchell. Here, Weir Mitchell and his colleagues studied nerve disorders and injuries, such as paralysis, spasms, and epilepsy (considered a nervous disease at the time). Detailed case histories were essential to such research and to medical care in general. Such record-keeping helped with follow-up care and rehabilitation, in hospitals and on the home front.

Information for this section was contributed by The College of Physicians of Philadelphia, in particular Jane E. Boyd, Ph.D., Wood Institute Research Associate, and Robert D. Hicks, Ph.D., Measey Chair for the History of Medicine and Director of the Mütter Museum & Historical Medical Library. For more information about The College of Physicians and the Mütter Museum, visit www.collphyphil.org.